Birth Control

When choosing to delay or prevent pregnancy, you have a lot of options. Birth control, or contraception, is available in a variety of forms, from daily pills to permanent surgical procedures. When deciding what type is right for you, it’s important to consider the following:

Your health
How frequently you engage in sexual activity
Whether you want to have children in the future

Natural family planning: Avoiding sexual intercourse or using an alternate form of birth control on days when you’re most likely to get pregnant
Barrier methods: Prevents sperm from getting to the egg; includes contraceptive sponges, diaphragms and condoms
Hormonal methods: Keeps women’s ovaries from releasing eggs; includes pills, patches, injections and vaginal rings.
IUDs: Devices which are implanted in the uterus to prevent pregnancy
Sterilization: Permanently prevents a woman from becoming pregnant or a man from being able to get a woman pregnant
Emergency contraception: Also known as the “morning after pill”; taken by a woman after having unprotected sex to prevent her from becoming pregnant

Where you get birth control depends on what type you’re planning to use. Barrier methods like condoms and emergency contraception are both sold over the counter. Diaphragms and IUDs must be fitted by a doctor. Most hormonal methods require a prescription, but some states—like Oregon and California—allow pharmacists to prescribe the pill. And sterilization is a surgical procedure.

Condoms are the only birth control type that also protect against STIs (sexually transmitted infections). When deciding on whether or not to use condoms, it’s important to weigh your risk based on your number of sexual partners and frequency of sexual activity.

If you aren’t sure which type is right for you, your primary care doctor or gynecologist can walk you through your options and the pros and cons for each.

Questions to Ask

When discussing your birth control options with your primary care doctor or gynecologist, you’ll probably have some questions. Review this list before your appointment, or print it out to bring with you.

Which method would be best for my age and level of sexual activity?
Is there a pill for birth control that will also take away my painful periods?
Can I get pregnant if I am breastfeeding?
Do cheaper generic birth control pills work as well?
Must I always use condoms if I have a history of herpes or HPV?
If I have never had a baby, can I still get an IUD inserted?
Would over-the-counter spermicides work for me?
Is natural family planning or withdrawal effective?
What should I do if I forgot to use contraceptives during intercourse?
Do I need to take a break from hormonal control periodically?
Are there any types of contraceptives that would be interfere with my other medications?
What type of contraception should I use if I am nursing my baby?
If I don’t want hormones, what method would work well for me?
Will I still be able to have children in the future with this method?
How long will it take to become fertile after I stop this method of birth control?
If there is stroke or breast cancer in my family history, can I still take the birth control pill?
Are vasectomies or tubal ligations reversible?

Options

When weighing birth control options, it’s important to consider the pros and cons of each. You should also evaluate which option works best for your lifestyle, sexual habits and overall health.

Condom

Sheath worn over the penis during intercourse (male condom) or inserted into the vagina (female condom); blocks sperm from entering cervical canal
87-90% effective at preventing pregnancy
Pros: Convenient; can be purchased in any drugstore without a prescription; easy to use; protects against STIs; good for five years from manufacture date
Cons: Good for one-time use only; male condoms can break and female condoms can slip out

Contraceptive Sponge

Soft, 2-inch round foam with spermicide inside that is inserted into the vagina; blocks sperm from entering cervix and inhibits sperm motion with spermicide
80-91% effective at preventing pregnancy
Pros: Convenient; can be purchased in any drugstore without a prescription; can be inserted up to 30 hours before sex; can be used while nursing
Cons: May be difficult to remove; can irritate the skin or cause dryness; must remain in vagina for six hours after intercourse; doesn’t protect against STIs

Cervical Cap

Small, thimble-shaped dome filled with spermicide and inserted over the cervix; prevents sperm from entering cervical canal
80% effective at preventing pregnancy
Pros: Can be worn for 48 hours; spermicide does not need to be added with each sexual encounter
Cons: Requires fitting by a doctor or nurse practitioner; may be difficult to insert; does not protect against STIs

Diaphragm

Soft, flexible dome-like cup inserted into the vagina with spermicide on both sides; blocks sperm from entering the cervix
82% effective at preventing pregnancy
Pros: Can insert 2-3 hours before intercourse; don’t need to take out in between acts of sexual intercourse within six hours
Cons: Requires fitting by a doctor or nurse practitioner before first use or after significant weight gain or loss; may be difficult to insert; does not protect against STIs

Spermicide

Inserted into vagina and melts to coat entire surface; kills sperm or prohibits motion of sperm
74% effective at preventing pregnancy
Pros: Comes in many form (jellies, foams, creams, films, suppositories); convenient; can be purchased at any drugstore without a prescription
Cons: Needs to be placed in the vagina at least 15 minutes prior to intercourse; must be inserted each time sexual intercourse happens; can be messy

Hormonal methods rely on delivery of estrogen or progesterone. They decrease a women’s fertility by preventing ovulation, thinning uterine walls and thickening cervical mucus.

Birth Control Pills (Oral Contraceptives)

Daily pill taken by mouth at the same time every day
92-99.7% effective at preventing pregnancy
Pros: Decreases menstrual flow, period cramps and risk of ovarian cancer; allows for spontaneity when having intercourse
Cons: Side effects may include headaches, nausea, weight gain and high blood pressure; does not protect against STIs; requires a prescription

Vaginal Ring

Flexible 2-inch ring inserted into the vagina and kept there for three weeks each month
92-99.7% effective at preventing pregnancy
Pros: Decreases menstrual flow and period cramps; allows for spontaneity when having intercourse
Cons: Side effects include nausea, headaches, weight gain, breast tenderness, high blood pressure and vaginal irritation; does not protect against STIs; requires a prescription

Depo-Provera

Injection of synthetic progesterone given every three months
97-99.7% effective at preventing pregnancy
Pros: Light or absent period; allows for spontaneity when having intercourse; reduces ovarian and uterine cancer risk
Cons: Side effects include weight gain, irregular bleeding, acne, mood swings, depression and headaches; may increase risk of osteoporosis; does not protect against STIs; requires a prescription

Contraceptive Patch

Adhesive patch applied weekly that delivers estrogen and progesterone through the skin
92-99.7% effective at preventing pregnancy
Pros: Easy to use, period flow and cramps decrease, allows for spontaneity when having intercourse
Cons: Side effects include headaches, breast tenderness, nausea, weight gain and skin irritation; may increase risk of breast cancer; does not protect against STIs; requires a prescription

Intrauterine Device (IUD)

Small device with string attached that is inserted into the uterus; changes uterine lining to prevent implantation if fertilization occurs
99% effective at preventing pregnancy

Withdrawal

Removal of erect penis from vagina before ejaculation; also known as pulling out or coitus interruptus
73% effective at preventing pregnancy
Pros: Free, convenient
Cons: Ejaculation may not be properly timed; if having intercourse more than once, sperm may still be present on penis from first encounter

Natural Family Planning

Daily temperature is taken to determine ovulation dates; abstinence from sexual intercourse or another contraception method is used around ovulation time; also known as the rhythm method
75% effective at preventing pregnancy
Pros: Free after initial purchase of thermometer; natural
Cons: May not accurately predict ovulation; if you forget to take your temperature first thing in the morning, you won’t be able to get an accurate reading for that day

Sterilization

In men, sterilization is done with vasectomy—surgical closure of tubes that carry sperm. In women, sterilization is done with tubal ligation—fallopian tubes are blocked so that the eggs can’t travel and unite with sperm.
99.98% effective in men; 99.5% effective in women

Emergency Contraception

Pills that can be taken after having unprotected sex to prevent pregnancy
Up to 89% effective in preventing pregnancy
Pros: Available over the counter without a prescription, can be taken up to five days after having unprotected sex
Cons: Side effects include nausea, vomiting, headache, breast tenderness and irregular periods; does not protect against STIs